Thursday, December 3, 1998 Published at 03:41 GMTHealthBrave new world of medicine around the cornerThe world of womb transplants, cures for blindness and spinal injuries and individually tailored drugs could be with us sooner than we think, says the BBC's Health Correspondent Richard Hannaford.

As with all utopian visions, this set of predictions, Clinical Futures by BMJ Publishing, from this set of eminent physicians both excites the reader with its amazing technological advances and horrifies them with its more sinister view of the nature of society.

It is, of course, the technological advances that impress us initially.

Tailored drugs

The list of possibilities is mouth-watering:

Professor Leslie Iversen (Visiting Professor at the Department of Pharmacology at Oxford
Universitry) believes that increased knowledge of brain function and nerve repair will enable doctors to cure the deaf and the blind.

Once inoperable spinal injuries could be repaired - giving the paralysed some independent mobility.

He argues that new insights into our own genetic blueprints - mapping our own genomes - will enable doctors to create carefully balanced and individually tailored drugs. Even ones that could rectify obesity or anorexia in one single dose. And specially grown organs - from genetically modified animals will enable us to replace damaged nerve cells in the treatment of such disease as Parkinson's.

Artificial wombs

But it is in the field of electronic engineering that Professor David Delpy (the Professor of Medical Physics at University College London) says will come many amazing new inventions. Infra-red analytic devices linked to sophisticated computers will be able to see inside our bodies.

Meanwhile, computers in our homes will be able to diagnose our symptoms immediately and book hospital appointments. Micro-chips implanted in our bodies could even be used to help other computers in the home adjust the
central heating, change our diet (through the Kitchen Computers Menu) and even alert specialists that we are ill.

Professor Catherine Peckham (Professor of Paediatric Medicine at the
Institute of Child Health in London) predicts that in the next 30 years women will be able to have uterus implants, if their womb is not functioning properly. Artificial wombs, where premature babies could safely continue their pregnancy and be delivered when fully grown.

Accepted norms

However, as in the best morality tales, there is a sting in the tale.

Despite - or perhaps because of these advances - Professor Peckham argues that society will become both inactive and passive, breeding a dependence on pills to sort out problems caused by an unhealthy lifestyle.

She also suggests that two distinct societal groups will emerge. The professional classes who will defer having children to their late 30s, and the lower paid who will have them in their teens and early 20s.

With the former group facing fertility difficulties, and there being more understanding of the impact of environment on the development of the young child, there may be calls for state intervention in parenthood - even for the state to forcibly confiscate children from parents who do not conform to accepted norms.

Other authors predict that with all these computers doing the initial diagnosis, and booking appointments with specialists, GPs will no longer be needed.

Indeed, robot surgeons and tele-medicine could result in senior doctors becoming as remote to patients as airline pilots are to their passengers.

Lifestyle drugs

How soon could all this occur? Well, much of the technological work is already under way. The genome project has nearly mapped every gene in the human body.

Many people are already undergoing genetic screening tests for cancer and Alzheimer's disease. Computers are already diagnosing and prescribing medicines in many GPs surgeries.

A woman in the UK who is paralysed has already had electrodes planted in her body, enabling her to stand and move her legs.

And pigs in Cambridgeshire have already had their genes altered to produce organs for human transplant.

Society also has seen an alarming increase in obesity, and reliance and fascination with lifestyle drugs - Viagra and the anti-fat pill Xenical to name but two.

A scientist in Japan has nearly perfected an artificial womb. And social workers already have the legal power to take children away from their parents if they feel they are in any danger.